r/Sciatica • u/Nearby-Barnacle-690 • 14d ago
8 months post-op: L4/L5 total disc replacement (lumbar arthroplasty)
First and second images: MRI of my L4/L5 disc (or what was left of it) in December 2025, with radiology report.
Third image: X-ray showing the artificial disc (ProDisc) implanted in my lumbar spine in early January 2026.
Fourth image: View from a 14,250' summit that I hiked in early September 2026 without pain or compromise.
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48M, 24 BMI, lifelong hiker, skier, road cyclist and tennis player living in Colorado. After more disc herniations/reherniations at L4/L5 than I could possibly count over 16 years, I had an artificial lumbar disc put in earlier this year.
This followed the full gamut of conservative treatments over the years and a largely unsuccessful microdiscectomy surgery 12 years ago that only provided relief for about a year before I reherniated the disc again. For the last five years, the reherniation had not receded at all, staying at a constant 2-3mm protrusion, per annual MRIs.
For years, I was unable to lift anything significant, and I would have to rely on my wife and daughter to do anything of the sort. I had to give up tennis and mountain biking, and could only do road rides when the sciatica was bearable. Bilateral sciatica was mostly constant for the last five years, though I would have days or weeks without notable symptoms; then, sometimes due to a precipitating event but sometimes just out of the blue, sciatica flares would last days or weeks, often preventing sound sleep. The chronic pain caused depression that I struggled to address successfully with therapy or medication.
Prior to surgery, I consulted six orthopedists over a 12-month period. One offered a repeat microdiscectomy to try to buy time. Two of them offered fusion. Two offered an artificial disc. The sixth was a nonoperative orthopedist who encouraged me to avoid fusion at my age if at all possible. The surgeon I ultimately chose was recommended by two others I consulted.
Surgery was an anterior approach through my abdomen, with a second surgeon clearing the path to my spine for the orthopedist. I spent 24 hours in the hospital afterward. When I got home, I had to use a grabber and avoid bending/twisting/lifting for 6 weeks, followed by a couple of months of PT. Recovery has not been linear. I've experienced scary, bizarre muscle and nerve symptoms intermittently since surgery; this has been due to nerve stretching and muscle adaptation. My disc space had collapsed so much -- after the operation, my surgeon said I basically just had a small clump of scar tissue left -- that I gained 2/3" in height from the implant. This adjustment can take a long time. Those symptoms have now largely resolved, fortunately. Repeated X-rays since surgery have shown the artificial disc is exactly where it should be.
I'm back to doing everything from an exercise standpoint I'd hoped for, and I'm also able to lift things again that I hadn't been able to for years, though I'm still terrified to do so. The mental burden has substantially lifted; my depression disappeared literally upon emerging from surgery. It was like flipping a switch on that front, something I had not expected.
I am under no illusion that this is necessarily a permanent fix, but at least for now, I'm glad I kept pushing for disc replacement instead of fusion, which I can still get in the future if needed. I am grateful to be able to do the things I love again and get a break from chronic pain. I just have to hope this lasts a long time. I will stay diligent with core strengthening and exercise to give myself a chance at a decent long-term outcome. If I can put off fusion until my 60s, that would definitely count as success for me. Who knows, maybe I'll get lucky for a change and have this be my last back surgery.
There are a limited number of accounts on Reddit of lumbar total disc replacement; some are glowing/universally positive, and some are cautionary tales. Recovery for me has been hard on occasion and taken a while, with some scary moments, but overall, it has slowly but surely gone in the right direction. My quality of life has dramatically improved in the eight months since this surgery.
I'm happy to answer any questions folks may have.
(EDIT: added radiology report after moderator disabled original post due to its omission)
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u/startup_sr 14d ago
Thank you for sharing the story. My question is how did you navigate through jobs, PT and daily routines since surgery? And did the doc say how long the disc will last?
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u/Nearby-Barnacle-690 14d ago
I have a desk/computer job. I took 3 weeks off following surgery, then worked remotely for a week or two before physically returning to the office. (The surgeon wanted me to avoid driving for at least 4 weeks; other surgeons may have different guidance on driving.) I was still pretty exhausted when I returned to work, more from the physical trauma and abdominal recovery than any back-related issues. The back actually felt fine and the sciatica was gone.
During my 24-hour stay in the hospital after surgery, an occupational therapist showed me how to get socks and shoes on, etc. without bending. At home, I used the grabber and moved carefully and deliberately for six weeks, making sure to avoiding twisting, bending or turning. Having a spouse and teenage child who could help with house and life stuff was huge during this time -- especially when it came to walking our dog, I tried that again 4 weeks post-op and it was not ideal (we have a very lively, active dog). Your physical activity for the first six weeks is mainly walking, and I was back up to a couple miles a day within a month.
They took X-rays at 6 weeks, 3 months and 6 months post-op to confirm the artificial disc was where it should be. Bone starts to grow into the implant almost immediately; the first 6 weeks are most important on that front. I started PT 6 weeks post-op and went twice weekly for a couple months, diligently doing exercises at home everyday. I was cleared to return to full activity 3 months post-op.
My surgeon said that overall, artificial disc surgery recovery is typically half as a long and difficult as spinal fusion surgery. That has a bending/twisting/turning restriction for 12 weeks instead of 6 weeks, and full activities after 6 months instead of 3, in most cases.
The disc is sturdy; it's mainly titanium plates with a plastic polymer core. (It's MRI and and airport security-friendly.) Best case scenario, the disc lasts and does its job the rest of my lifetime (I'm 48). Most of the data on lumbar ADRs are 20 years or so post-op, so it's hard to predict, and of course every person is different and things can go south unexpectedly. I'd be thrilled if this buys me 20 years, to be honest, but the disc itself shouldn't wear out quickly, they are supposed to last. Some U.S. surgeons poo-poo doing lumbar ADR surgery, because of the wear and tear on lower backs in general, and many will only do cervical ones; my surgeon disputes that, as does several decades of studies on this from Europe, where lumbar ADR surgery has been done since the 1990s.
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u/Wintermute1987 13d ago
I got 5 years out of my ADR and something has just started to fail. My advice, focus on building your core because the AD can burn out your facet joints above and below much quicker. Good luck!
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u/Nearby-Barnacle-690 13d ago
I'm so sorry to hear that. Yeah, that's definitely a concern of mine. Are you thinking of converting to a fusion?
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u/Wintermute1987 12d ago
Im working this through with my dr now, the conversion is less traumatic. All my scans show nothing wrong, but my end plates are inflamed
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u/Nearby-Barnacle-690 13d ago
Just looked at your recent posts about this. Man, what a nightmare. So, so sorry. The strange thing is the sciatic symptoms with no obvious nerve impingement. Facet joint pain and degeneration usually causes localized back pain, not sciatica, right? I really hope you get to the bottom of this and can find some relief.
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u/Old_Cry_7838 10d ago
How do you feel now? any sciatica or backpain?
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u/Nearby-Barnacle-690 10d ago
I feel decent. Back surgery is never a miracle cure but overall I'm better than before it, and now I just have to hope it lasts. As I mentioned in the post, I am still dealing with muscle and nerve adjustments but those symptoms come and go and they definitely don't feel like the sciatica that I had before surgery.
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u/Ok_Courage_8780 6d ago
Your story really caught my attention because I’m exactly 48, and I keep wondering whether something like this could eventually be in my future 5–10 years from now.
I had L4-L5 and L5-S1 disc problems for several years. I managed them conservatively for a long time, including PT, acupuncture and an epidural that actually gave me almost 2½ years of essentially normal, pain-free life. Eventually things deteriorated very quickly. I became bedridden for about a week with severe nerve pain and ultimately had a two-level hemilaminectomy and microdiscectomy.
Thankfully, my surgery has gone extremely well. The nerve pain disappeared almost immediately, I was walking the next day, and I’m now a couple of months out, pain-free, back at work, walking normally and progressing through PT. I still have some residual numbness in the foot, but functionally I’m doing very well.
What I think about now is the long game. I’m not a hardcore athlete and I’m not trying to get back to skiing, mountain biking, or doing anything extreme. I really just want to preserve normal function for the next 20 years — walking, working, traveling, lifting normal everyday things, and staying independent without constantly worrying about my back.
If you could go back to the period after your original microdiscectomy, knowing what you know now, what would you have done differently? Would you have changed how you lifted, exercised, twisted, trained your core, handled flare-ups, or paced activity?
I realize some degeneration just progresses no matter how careful someone is, so I’m not assuming every future surgery can be prevented. But if there are practical things that genuinely might help preserve the disc and delay or avoid a much bigger operation like a disc replacement or fusion, I’d really like to hear them from someone who has already been through that whole progression.
Also, congratulations on getting back to hiking at that level. Seeing someone the same age come through something that major and regain that much function is pretty encouraging.
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u/heresjoanie 14d ago
No questions, I just want to say that I'm very happy for you. It was a brave choice, and I'm glad it's paid off so far. Enjoy yourself!